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U.S. Health Reform Starts to Take Hold
Date:7/18/2010

te health insurance exchanges and the availability of premium subsidies for low-income individuals and families, don't take effect until 2014.

Numerous states have filed suit or introduced legislation seeking to block the federal law or provisions of the legislation. A key sticking point is the requirement that most individuals obtain health insurance coverage or pay a penalty.

Virginia Attorney General Ken Cuccinelli contends that the federal government's mandate overreaches its authority. A federal judge is expected to rule by the end of the month on a U.S. Department of Justice motion to dismiss the state's lawsuit, The Roanoke Times reported. The Justice Department has filed a similar motion in a case brought by the state of Florida and joined by 19 states and the National Federation of Independent Business.

Missouri Lt. Gov. Peter Kinder is the latest to join the fray. His suit, filed July 7, alleges that the law will drive up the cost of health care in Missouri and force people to purchase coverage they don't want or need.

Meanwhile, many employers and insurers are moving ahead with implementation of the law. Here's how some of the initial provisions are shaking out:

Seniors with sizable drug costs

The federal law begins phasing in plans to close the "donut hole," the gap in Medicare Part D coverage during which older Americans must pay 100 percent of their drug costs. As a first step, the federal government is sending every eligible senior who reaches the gap this year -- an estimated 4 million people -- a check for $250.

The first round of tax-free disbursements went out last month. A second round of checks was mailed last week, and those mailings will occur monthly throughout 2010 as seniors hit the donut hole, HHS says.

People with pre-existing health conditions

By 2014, the law prohibits insurers from discriminating against adults with pre-existing conditions. In the interim, adults who have be
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